Idiopathic intracranial hypertension with VI CN palsy - pediatric
Diagnosis almost certain
Presentation
Bilateral papilledema grade II with right VI nerve palsy.
Patient Data
Age: 11 years
Gender: Female
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The MRI sequences demonstrate:
- vertical tortuosity of the optic nerves
- enlargement of the subarachnoid space around the optic nerves
- flattening of the posterior sclera bilaterally
- mild protrusion of the optic nerve heads
- the cerebral venous sinuses are patent on postcontrast sequences with no significant stenosis on the MRV
- no mass lesion is seen at the infra- or supratentorial level.
Case Discussion
MRI features are most consistent with idiopathic intracranial hypertension.
Idiopathic intracranial hypertension is rare in the pediatric population. A sixth cranial nerve palsy is sometimes found on neurological examination.